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There’s Nothing Cruel About Trump’s ‘Medicare Cuts’

President Trump submitted his 2020 budget last week, and, as
with nearly all presidential budgets before it, two things
immediately ­became apparent: First, there was zero chance it would
be ­enacted as drafted, and, second, there was no limit to
congressional hysteria and demagoguery in response.

Among the biggest sources of hysteria was the president’s
proposal to reduce the growth in Medicare spending by $845 billion
over the next decade. Democrats immediately denounced the cuts as
“devastating” and “cruel.” It’s only
a matter of time until we see the first ad showing Trump throwing
grandma and her wheelchair over a cliff.

But fact is, Trump’s plan is far less radical than
portrayed.

Actually, they are far
less than what is needed to bring Medicare back into
balance.

For starters, while the proposed reductions sound big, they
aren’t. Actually, they are far less than what is needed to
bring Medicare back into balance. Over the next 10 years, Medicare
is projected to spend more than $10.2 trillion, meaning the
president’s proposed cuts amount to less than 9 percent of
the entitlement’s projected expenditures.

In the typical Washington way, the cuts aren’t actually
cuts but rather reductions in the rate of increase. Even ­after the
supposed “cuts,” Medicare spending is projected to
nearly double by 2030.

For example, $260 billion in projected savings come from
­efforts to prevent hospitals from increasing reimbursement levels
by buying up physician practices. The new policy would pay the same
reimbursements rate ­regardless of whether a patient visit took
place in a hospital or a doctor’s off-site office.

Another $69 billion results from changes in the way Medicare
­reimburses for prescription drugs. Yes, those changes mean some
­seniors could face higher copayments. But at the same time,
­seniors with very high drug costs would actually end up paying
less. One can argue about whether this is the best way to reduce
the cost of prescription drugs, but it is clearly a goal that
Democrats share. Or used to.

Then, too, President Barack Obama implemented some $714 billion
in similar reimbursement reductions to help fund ObamaCare. Mitt
Romney famously attacked Obama for those cuts during the 2012
presidential debates. And Obama defended himself by claiming that
cutting provider payments wasn’t the same as cutting benefits
to seniors. Those changes don’t reduce benefits to seniors
“by a single dime,” Obama passionately declared.

Bipartisan hypocrisy aside, ­reductions in provider payments
aren’t without consequences. If payments drop too low,
physicians could be discouraged from providing care or accepting
Medicare patients at all. Still, that seems like a strange
complaint from Democrats, many of whom have ­embraced a
Medicare-for-All plan that the Mercatus Center estimates would
require as much as a 40 percent cut in ­reimbursement rates.

Most important, Medicare desperately needs to be ­reformed.

In the coming decades, the program will spend trillions of
dollars more in benefits than it takes in through taxes. A married
couple that earns $110,000 in wages will pay roughly $140,000 in
Medicare taxes and premiums over their lifetime. That same couple
can expect to receive more than $422,000 in benefits. That’s
not exactly a recipe for fiscal stability.

Our national debt currently exceeds $22 trillion. The
president’s budget expects it to top $31 trillion in a
decade. Simply put, there is no way to balance the budget and
reduce our debt without reforming the three big entitlement
programs, Medicare, Medicaid and Social Security, which account for
half of all federal spending.

It is perfectly reasonable to question how the president would
reform Medicare, but in that case critics have an obligation to
explain how they would protect our children and grandchildren from
this growing tsunami of red ink.

There are plenty of reasons to criticize the president’s
budget. It doesn’t even try to balance the budget for 15
years, and then only under the rosiest of rosy scenarios. The hike
in defense spending seems both excessive and divorced from any real
strategy, while domestic spending cuts are often arbitrary or
unlikely to realize the savings projected. It is stuffed with
corporate welfare and pet projects. It invites another exhausting
fight over The Wall.

But the hysteria surrounding the president’s
not-so-radical Medicare proposals is more about politics than
policy.